In preparation for surgery in April my surgeon wants me to do a bottle of Magnesium Citrate the night before I am admitted. And actually, the next day I will have more bowel prep as my surgery is the day after admittance I've never used Mag Citrate (but have used Milk Of Magnesia), anyone have experience on how long before it kicks in, and how long does the ensuing clean out last? (yeah I know it's different for everyone; I seem to be respond pretty quickly with prescribed bowel preps)

Magnesium CcitrateA magnesium salt of citric acid, is a chemical agent used medicinally as a saline laxative and to completely empty the bowel prior to a major surgery or colonoscopy. It is available without a prescription, both as a generic brand or under the brand name Citromag or Citroma. It is also used as a magnesium supplement in pills. The magnesium content of magnesium citrate corresponds to about 11% by mass.

Mechanism of actionMagnesium citrate works by attracting water through the tissues by a process known as osmosis. Once in the intestine, it can attract enough water into the intestine to induce defecation. The additional water helps to create more feces, which naturally stimulates bowel motility. This means it can also be used to treat rectal and colon problems. Magnesium citrate functions best on an empty stomach, and should always be followed with a full (eight ounce) glass of water or juice to help the magnesium citrate absorb properly and help prevent any complications. Magnesium citrate is generally not a harmful substance, but care should be taken by consulting a health-care professional if any adverse health problems are suspected or experienced.

Use and dosageThe maximum Upper Tolerable Limit for magnesium in supplement form for adults is 350 mg per day of elemental magnesium according to the National Institutes of Health (NIH). In addition, according to the NIH, total dietary requirements for magnesium from all sources (i.e. food and supplements) is 320–420 mg of elemental magnesium per day, though there is no UTL for dietary Magnesium. As a laxative syrup with a concentration of 1.745 g of magnesium citrate per fl. oz, a typical dose for adults and children twelve years or older is between 7 and 10 US fluid ounces (210 and 300 ml; 7.3 and 10 imp fl oz), followed immediately with a full 8 US fluid ounces (240 ml; 8.3 imp fl oz) glass of water. Consuming an adult dose of 10 oz of laxative syrup (@ 1.745 g/oz) implies a consumption of 17.45 g of magnesium citrate in a single 10 oz dose resulting in a consumption of approximately 2.0 g of elemental magnesium per single dose. Given that this laxative dose contains five times the recommended nutritional dose for magnesium, caution should be taken to avoid prolonged usage (i.e. over five days) and to follow the manufacturer's instructions strictly. For children between three and twelve years of age, the typical dose is roughly half that, based on physician recommendation. Magnesium citrate is not recommended for use in children and infants two years of age or less.Although less common, as a magnesium supplement the citrate form is sometimes used due to its increased bio-availability to other common pill forms, such as magnesium oxide. However, according to some studies magnesium gluconate may be more bio-available than magnesium citrate. Higher doses, up to 500 mg daily, have been used effectively in the prophylaxis of migraines, in combination with riboflavin (vitamin B2) 400 mg and, in some cases, a supplement of coenzyme Q10. Similar dosages apply when used as a supplement to help prevention of kidney stones.Magnesium citrate, as a supplement in pill form, is useful for the prevention of kidney stones.

Side effectsIt is always important to correctly follow the prescribed doses; extreme magnesium overdose can result in serious complication such as slow heart beat, low blood pressure, nausea, drowsiness, etc. If severe enough, an overdose can even result in coma or death.[5] However, a moderate overdose will be excreted through the kidneys, unless one suffers from serious kidney problems.Magnesium citrate solutions generally PRODUCES BOWEL MOVEMENT IN ONE HALF TO SIX HOURS[emphais by me]. Rectal bleeding or failure to have a bowel movement after use could be signs of a serious condition.

I had this for my HIPEC as my surgeon only wanted me somewhat cleaned out, since we weren't expecting any bowel resections. Took about 2 hours to kick in and just produced maybe 3 BM's. It tastes awful, but it's only a pint of liquid which is bearable, especially if ice cold. I thought it didn't taste as bad as the Lytely crap though that's just my personal opinion. Anyway, since it's just a few oz of liquid it's not like I was crapping clear like you get from a full scope-clean. Sounds like your surgeon is being a little extra cautious having you do the citrate BEFORE a prep

11/13/09 5cm Stage IV 9/25 lymph nodes w/2cm peritoneal met at 29 YoA12/15/09 LA right hemi-colectomy6/16/10 Folfox FINISHED8/10/10 Prophylactic HIPEC10/9/10 got Married Still NED and living life to the fullest

SkiFletch wrote:I had this for my HIPEC as my surgeon only wanted me somewhat cleaned out, since we weren't expecting any bowel resections. Took about 2 hours to kick in and just produced maybe 3 BM's. It tastes awful, but it's only a pint of liquid which is bearable, especially if ice cold. I thought it didn't taste as bad as the Lytely crap though that's just my personal opinion. Anyway, since it's just a few oz of liquid it's not like I was crapping clear like you get from a full scope-clean. Sounds like your surgeon is being a little extra cautious having you do the citrate BEFORE a prep

Recent scopes have found that I am pretty constricted at the original resection site, so I think the surgeon is concerned about getting a good clean out. He wants me on a full liquid diet 2 days before surgery; that night I will do the mag.citrate. Then next day admitted and I guess clear liquid diet maybe and a cleanout that night before surgery. They are planning a resection in addition to the HIPEC.

I just went through a cleanout for a colonoscopy last week and based on what was coming out, I was pretty cleaned out by that.

My GI doc has me drink the mag. citrate and then do one of the lytelys as my bowel prep before colonoscopies. It's miserable!

I actually find the mag citrate to be worse than GoLytely, taste-wise. It has to be ice cold, as SkiFletch said, and I have to drink it all at once with my nose plugged! There are often cherry or grape flavored options which are somewhat better than plain mag. citrate. After I get it down, it takes about an hour and a half and then I have 2-3 fairly intense BMs. It does not clean you out.

Oh yeah, definitely go for a flavored one. I couldn't imagine drinking that nastyness unflavored. I chose grape myself and just picked it up from the pharmacy at the corner. It tastes what I would imagine grape juice concentrate mixed in seawater would taste. That's my best description. I still prefer that to lytely, that stuff tastes like vomit in a glass

11/13/09 5cm Stage IV 9/25 lymph nodes w/2cm peritoneal met at 29 YoA12/15/09 LA right hemi-colectomy6/16/10 Folfox FINISHED8/10/10 Prophylactic HIPEC10/9/10 got Married Still NED and living life to the fullest

SkiFletch wrote:Oh yeah, definitely go for a flavored one. I couldn't imagine drinking that nastyness unflavored. I chose grape myself and just picked it up from the pharmacy at the corner. It tastes what I would imagine grape juice concentrate mixed in seawater would taste. That's my best description. I still prefer that to lytely, that stuff tastes like vomit in a glass

The "vomit in a glass" really made me laugh! I hope I don't rip my steri strips!I don't have much to add, but I will be scheduling my HIPEC soon. Take good notes. I will be keeping you in my thoughts for a quick recovery.